Effectiveness and safety of third-line advanced therapies in patients with ulcerative colitis: A multicentre retrospective cohort study : Third-line treatment in UC - 05/10/25
Highlights |
• | What is already known on this subject?
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• | What are the new findings?
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• | How might it impact on clinical practice in the foreseeable future?
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Summary |
Background |
The effectiveness of advanced therapies beyond second-line therapies has been poorly described in patients with ulcerative colitis (UC).
Aim |
To describe the outcomes of third-line advanced therapy in patients with UC in a real-world setting.
Methods |
We conducted a multicentre retrospective study in patients with UC who received third-line advanced therapy after the failure of a first-line anti-TNF agent and second-line vedolizumab. The primary endpoints were steroid-free clinical remission at weeks 14 and 54.
Results |
We analysed 237 therapeutic sequences in 150 patients (55 with an anti-TNF agent, 80 with tofacitinib, and 102 with ustekinumab), accounting for 245.3 patient-years. Steroid-free clinical remission at week 14 was achieved in 14 (25.5 %) patients treated with an anti-TNF agent, 40 (50.0 %) with tofacitinib, and 54 (52.9 %) with ustekinumab (RR = 1.96 [1.19–3.25] for tofacitinib and RR = 2.08 [1.28–3.39] for ustekinumab, compared with an anti-TNF agent, respectively). Steroid-free clinical remission at week 54 was achieved in 16 (29.1 %) patients in the anti-TNF group, 37 (46.2 %) in the tofacitinib group and 56 (55.4 %) in the ustekinumab group (RR = 3.07 [0.98–9.60] for tofacitinib and RR = 3.09 [1.01–9.43] for ustekinumab, compared with anti-TNF, respectively). In total, 13.7 % of the patients underwent colectomy. Adverse events occurred in 94 (39.7 %) patients and were less frequent with ustekinumab.
Conclusion |
In this retrospective study, third-line advanced therapies resulted in a high rate of steroid-free clinical remission at weeks 14 and 54, especially in patients treated with ustekinumab and tofacitinib.
Le texte complet de cet article est disponible en PDF.Keywords : Ulcerative colitis, Biologics, JAK inhibitor, Refractory
Abbreviations : : ANOVA, anti-TNF SC, AP-HP, BMI, CRP, ECCO, GOL/ADA, IBD, ICD-10, JAKi, L, MES, OR, SD, UC, UCEIS, US, VTE, W
Plan
Vol 49 - N° 9
Article 102699- novembre 2025 Retour au numéro
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